Cognitive Exercise

This is a cognitive exercise. Normally, a cognitive therapy session would take place with the guidance of a counselor or psychiatrist. However, there are some things you can do on your own to improve your cognitive thinking skills.

The first thing to do in this cognitive exercise is learn to tune in to your assumptions. Part of the reason we don’t question our own assumptions, is because we don’t know what they are.

Use a time when you feel yourself getting upset or having an emotional reaction, to listen to your self sentences and find the assumption that underlies your thoughts. You can do this most effectively by writing it out. Grab a piece of paper (or create a new document on your computer) and write out the following:

Situation/Problem

Here is where you write down what is happening… if you are having anxiety without a known cause, write down the physical symptoms you are experiencing. For example, “trouble breathing, muscle spasms, trouble thinking, and dizziness.”

Thought

Write out any thoughts/ideas you are having here. They may seem random, and some of them may be just and abstract idea. This is normal. An example would look something like this: “Oh no! not again! This ALWAYS happens!” “Why am I so crazy?” “I have to get a hold of myself!” “this is so embarrassing.” “This is so stupid” “I’m such an idiot” “what will they think?” “Knock it off!”

Feeling/Effect

Write down the emotions or associated with this situation. Such as “embarrassed,” “scared”, “frustrated” “inadequate” “sad” feelings associated with this situation. Such as “embarrassed,” “scared”, “frustrated” “inadequate” “sad”

Behavior/Outcome

Write down the way you are behaving in reaction to the situation, thoughts, and feelings. For example, “isolating myself”

Here Is Another Example Of This process:

Problem/Situation

Difficulty talking to people.

Thoughts

“Nobody likes me.” “I’m not interesting” “if I have a problem nobody cares” “I’m stupid” “nobody understands me”

Feelings/Effect

Nervous, embarrassed, lonely, uncomfortable, sad, worthless.

Behavior/Outcome

Withdrawing from social activities, avoiding conversations with others.

Once you have identified the thoughts and feelings surrounding your situation, you can begin to question your assumptions.

Start by writing out the situation using the following format. I will use the second example for this cognitive exercise :

Problem/Situation : Difficulty Talking To People.

Write out an actual event or stream of thoughts ,daydream, or recollection leading to unpleasant emotions. For example:

“I was embarrassed at Tracy’s wedding because I didn’t know what to say during the toast.”

“I feel left out at work because most of the other employees are close personal friends with the supervisor.”

“Everyone might ignore me.”

Feelings/Effect

Rate the intensity of your feelings here. 1-100%Embarrassed 80%, nervous 98%, lonely 100%, uncomfortable 90%, sad 75%, worthless 95%

(Notice how distorted thinking styles can push our anxiety level way above 100%!)

Thoughts

List your automatic thoughts again, and rate how much you really believe them 1-100%“Nobody likes me” 90% “ I’m not interesting” 85% “If I have a problem nobody cares” 75% “I’m stupid” 50% “nobody understands me” 99%

Distortions

Using the list of Distorted Thinking Styles, identify distortions present in each automatic assumption.

“Nobody likes me” – all or nothing, generalizing, emotional reasoning.

“I’m not interesting” – all or nothing, emotional reasoning, labeling.

“If I have a problem nobody cares”- generalizing, mental filter, emotional reasoning.

“I’m stupid”- labeling.

“Nobody understands me”-all or nothing, generalizing, emotional reasoning,

Rational Response

The next step in this cognitive exercise is to write out rational responses to your automatic thoughts, and rate your belief of them 1-100%

“Nobody likes me” – “Judy likes me, so does Leah, Joan, Jeanine, Carrie, Elaina, Laura, and Wendy”. 100%

“I’m not interesting” – “Maybe if I think about it, I can come up with something to say that might interest someone 85%

“If I have a problem nobody cares” – “Several people care about me, and would help me with my problems if they knew how. Or had enough time” 95%

“I’m stupid” – “I read well, and I always get a fairly high score when I play trivia games” 100%

“Nobody understands me”. “I’m glad I have Elaina in my life. She understands me better than anyone.” 95%

Outcome

Re-rate belief in automatic thoughts.

“Nobody likes me.” 1%

“I’m not interesting”. 3%

“If I have a problem nobody cares.” 5%

“I’m stupid” 2%

“Nobody understands me” 1%

Now how do you feel about the situation?

More confident.

The more you do this cognitive exercise , the easier it will become to hear and identify your automatic thoughts and thinking styles.

Treatment Plan Day 6